KUALA LUMPUR, August 23 — The Malaysian Medical Association (MMA) has expressed deep concern over the Ministry of Health’s (MOH) recent decision to adjust treatment regimens for diabetes patients, amid a severe insulin shortage across the country.
While acknowledging the MOH’s efforts to address the unprecedented shortage of human insulin through emergency measures, the MMA said it is “gravely worried” about the potential impact on patient outcomes, particularly for those dependent on human insulin.
“The decision to switch patients from human insulin to more expensive alternatives, such as SGLT2 inhibitors and insulin analogs, raises several significant concerns.
“While these alternatives may be effective for some, the sudden transition, driven by necessity rather than clinical preference, may pose risks, especially if patients are not adequately monitored or if they do not respond well to the new treatments,” MMA president Dr Azizan Abdul Aziz said in a statement today.
The MMA highlighted these concerns:
- Patient Safety and Treatment Efficacy: The shift to alternative treatments, while necessary, must be handled with extreme caution. Patients with complex health conditions — such as those with Type 1 diabetes, pregnant women, and those with severe kidney failure — are particularly vulnerable. Any changes to their treatment must be closely monitored to prevent deterioration in their health.
- Potential for Worsening Health Outcomes: The criteria for switching from human insulin to alternative treatments must be strictly followed. However, these should not replace the individualised care each patient deserves. The risk of worsening glycemic control and increased complications must be mitigated through rigorous follow-ups and patient education.
- Supply Chain Stability: The current crisis highlights the need for a more robust and diversified supply chain for essential medications like insulin. The MMA urges the MOH to quickly identify alternative manufacturers and work to prevent future shortages.
The MMA has called for transparency and open communication with the public and health care providers as the situation unfolds.
“We strongly recommend that the MOH establish a nationwide committee to oversee the management of stock and supply of essential medicines,” Dr Azizan said.
CodeBlue previously reported Health director-general Dr Muhammad Radzi Abu Hassan’s circular issued yesterday on the MOH’s plans to switch 45 per cent of eligible diabetes patients currently on human insulin treatment to insulin analog or SGLT2 inhibitors; 55 per cent can remain on human insulin treatment, if there is enough supply.
SGLT2 inhibitors – which improve glycaemic control by causing the kidneys to remove sugar from the body through urine – are also much more costly than human insulin.
The Health DG’s circular further listed priority groups for insulin naive patients to begin insulin treatment: Type 1 diabetes patients, pregnant women, and patients with serious kidney failure.
